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Article ; Online: Serum IGF-binding protein 2 (IGFBP-2) concentrations change early after gastric bypass bariatric surgery revealing a possible marker of leptin sensitivity in obese subjects.

Ceccarini, Giovanni / Pelosini, Caterina / Ferrari, Federica / Magno, Silvia / Vitti, Jacopo / Salvetti, Guido / Moretto, Carlo / Marioni, Antonio / Buccianti, Piero / Piaggi, Paolo / Maffei, Margherita / Santini, Ferruccio

Endocrine

2019 Volume 65, Issue 1, Page(s) 86–93

Abstract: Purpose: Expression of IGFBP-2 in mice is regulated by leptin. Over-expression of IGFBP-2 is associated with reduced caloric intake and resistance to weight gain. Hormonal variations contributing to weight loss occur very early after bariatric surgery ... ...

Abstract	Purpose: Expression of IGFBP-2 in mice is regulated by leptin. Over-expression of IGFBP-2 is associated with reduced caloric intake and resistance to weight gain. Hormonal variations contributing to weight loss occur very early after bariatric surgery but have not been fully elucidated. We evaluated IGFBP-2 serum changes after bariatric surgery and their relationship with leptin variations to test the hypothesis that an increase of leptin sensitivity may explain some of the effects of gastric bypass. Methods: This is a historical prospective study. Fifty-one obese patients (41 women e 10 men), 9 non-obese surgical controls and 41 lean matched controls were studied. Serum IGFBP-2 and leptin were measured after bariatric bypass surgery at various time points up to 18 months, after non-bariatric laparoscopic surgery in a control group, and in lean matched controls. Results: Compared to lean controls, serum IGFBP-2 levels were lower in obese patients. After gastric bypass, IGFBP-2 significantly increased at 3 days and became normal before the occurrence of relevant changes in body weight, remaining stable up to 18 months after surgery. IGFBP-2/leptin ratio increased early after surgery and became normal after one year. Conclusions: After gastric bypass, serum IGFBP-2 increases in a window of time when variations of hormones mediating the effects of bariatric surgery occur. Our results suggest that IGFBP-2, a leptin-regulated protein, may be an in-vivo marker of leptin action. If this is the case, an early improvement of leptin sensitivity might contribute to the anorectic effect of gastric bypass.
MeSH term(s)	Adult ; Biomarkers/analysis ; Biomarkers/blood ; Case-Control Studies ; Drug Resistance ; Female ; Gastric Bypass ; Humans ; Insulin-Like Growth Factor Binding Protein 2/analysis ; Insulin-Like Growth Factor Binding Protein 2/blood ; Leptin/metabolism ; Male ; Middle Aged ; Obesity/blood ; Obesity/diagnosis ; Obesity/metabolism ; Obesity/surgery ; Postoperative Period ; Prognosis ; Treatment Outcome ; Young Adult
Chemical Substances	Biomarkers ; Insulin-Like Growth Factor Binding Protein 2 ; Leptin
Language	English
Publishing date	2019-04-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1194484-5
ISSN	1559-0100 ; 1355-008X ; 0969-711X
ISSN (online)	1559-0100
ISSN	1355-008X ; 0969-711X
DOI	10.1007/s12020-019-01915-y
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Article ; Online: Clinical outcomes and quality of life associated with the use of a biosynthetic mesh for complex ventral hernia repair: analysis of the "Italian Hernia Club" registry.

Rognoni, Carla / Cuccurullo, Diego / Borsoi, Ludovica / Bonavina, Luigi / Asti, Emanuele / Crovella, Feliciano / Bassi, Uberto Andrea / Carbone, Gabriele / Guerini, Francesca / De Paolis, Paolo / Pessione, Silvia / Greco, Vincenzo Maria / Baccarini, Elisabetta / Soliani, Giorgio / Sagnelli, Carlo / Crovella, Clotilde / Trapani, Vincenzo / De Nisco, Carlo / Eugeni, Emilio /

Zanzi, Federico / De Nicola, Enrico / Marioni, Antonio / Rosignoli, Alessandro / Silvestro, Roberto / Tarricone, Rosanna / Piccoli, Micaela

Scientific reports

2020 Volume 10, Issue 1, Page(s) 10706

Abstract: With the development of newer meshes and approaches to hernia repair, it is currently difficult to evaluate their performances while considering the patients' perspective. The aim of the study was to assess the clinical outcomes and quality of life ... ...

Abstract	With the development of newer meshes and approaches to hernia repair, it is currently difficult to evaluate their performances while considering the patients' perspective. The aim of the study was to assess the clinical outcomes and quality of life consequences of abdominal hernia repairs performed in Italy using Phasix and Phasix ST meshes through the analysis of real-world data to support the choice of new generation biosynthetic meshes. An observational, prospective, multicentre study was conducted in 10 Italian clinical centres from May 2015 to February 2018 and in 15 Italian clinical centres from March 2018 to May 2019. The evaluation focused on patients with VHWG grade II-III who underwent primary ventral hernia repair or incisional hernia intervention with a follow-up of at least 18 months. Primary endpoints included complications' rates, and secondary outcomes focused on patient quality of life as measured by the EuroQol questionnaire. Seventy-five patients were analysed. The main complications were: 1.3% infected mesh removal, 4.0% superficial infection requiring procedural intervention, 0% deep/organ infection, 8.0% recurrence, 5.3% reintervention, and 6.7% drained seroma. The mean quality of life utility values ranged from 0.768 (baseline) to 0.967 (36 months). To date, Phasix meshes have proven to be suitable prostheses in preventing recurrence, with promising outcomes in terms of early and late complications and in improving patient quality of life.
MeSH term(s)	Abdominal Wall/pathology ; Adult ; Aged ; Aged, 80 and over ; Biocompatible Materials/therapeutic use ; Electronic Health Records/statistics & numerical data ; Female ; Hernia, Inguinal/surgery ; Hernia, Ventral/surgery ; Herniorrhaphy/adverse effects ; Herniorrhaphy/methods ; Humans ; Italy ; Male ; Middle Aged ; Prospective Studies ; Quality of Life/psychology ; Recurrence ; Secondary Prevention ; Surgical Mesh ; Surveys and Questionnaires ; Treatment Outcome
Chemical Substances	Biocompatible Materials
Keywords	covid19
Language	English
Publishing date	2020-07-01
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-020-67821-w
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Article: Gestione del paziente sottoposto a colecistectomia laparoscopica in One Day Surgery.

Isola, Alessandra / Cattano, Davide / Madrigali, Stefano / Marioni, Antonio / Buccianti, Piero

Professioni infermieristiche

2008 Volume 61, Issue 4, Page(s) 202–209

Abstract: The introduction of new surgical techniques, that allow rapid functional recovery, and short-lasting anesthetics has made it possible to include a wider range of procedures in day surgery regimes. Videolaparoscopic colecistectomy (VLC) , a video-assisted ...

Title translation	Nursing in a Day Surgery regime: experience in laparoscopic colecistectomy.
Abstract	The introduction of new surgical techniques, that allow rapid functional recovery, and short-lasting anesthetics has made it possible to include a wider range of procedures in day surgery regimes. Videolaparoscopic colecistectomy (VLC) , a video-assisted surgical model, is one of these. The University Hospital of Pisa has responded to the growing needs of clients by creating an autonomous unit for this purpose, the Day Surgery Service for general surgery, in order to identify an efficient model in terms of organization, management and quality. This model is described paying particular attention to the role of nurses. In our experience, day surgery for colecistic pathologies proved to be safe and reliable and creation of separate channels for day surgery patients increases the level of client satisfaction.
MeSH term(s)	Ambulatory Surgical Procedures/nursing ; Cholecystectomy, Laparoscopic/nursing ; Humans
Language	Italian
Publishing date	2008-10
Publishing country	Italy
Document type	English Abstract ; Journal Article
ZDB-ID	1217777-5
ISSN	0033-0205
ISSN	0033-0205
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Article ; Online: Defining the characteristics of certified hernia centers in Italy: The Italian society of hernia and abdominal wall surgery workgroup consensus on systematic reviews of the best available evidences.

Stabilini, Cesare / Cavallaro, Giuseppe / Bocchi, Paolo / Campanelli, Giampiero / Carlucci, Michele / Ceci, Francesca / Crovella, Feliciano / Cuccurullo, Diego / Fei, Landino / Gianetta, Ezio / Gossetti, Francesco / Greco, Dalila Patrizia / Iorio, Olga / Ipponi, Pierluigi / Marioni, Antonio / Merola, Giovanni / Negro, Paolo / Palombo, Denise / Bracale, Umberto

International journal of surgery (London, England)

2018 Volume 54, Issue Pt A, Page(s) 222–235

Abstract: Background: The terms "Hernia Center" (HC) and Hernia Surgeon" (HS) have gained more and more popularity in recent years. Nevertheless, there is lack of protocols and methods for certification of their activities and results. The Italian Society of ... ...

Abstract	Background: The terms "Hernia Center" (HC) and Hernia Surgeon" (HS) have gained more and more popularity in recent years. Nevertheless, there is lack of protocols and methods for certification of their activities and results. The Italian Society of Hernia and Abdominal Wall Surgery proposes a method for different levels of certification. Methods: The national board created a commission, with the task to define principles and structure of an accreditation program. The discussion of each topic was preceded by a Systematic Review, according to PRISMA Guidelines and Methodology. In case of lack or inadequate data from literature, the parameter was fixed trough a Commission discussion. Results: The Commission defined a certification process including: "FLC - First level Certification": restricted to single surgeon, it is given under request and proof of a formal completion of the learning curve process for the basic procedures and an adequate year volume of operations. "Second level certification": Referral Center for Abdominal Wall Surgery. It is a public or private structure run by at least two already certified and confirmed FLC surgeons. "Third level certification": High Specialization Center for Abdominal Wall Surgery. It is a public or private structure, already confirmed as Referral Centers, run by at least three surgeons (two certified and confirmed with FLC and one research fellow in abdominal wall surgery). Both levels of certification have to meet the Surgical Requirements and facilities criteria fixed by the Commission. Conclusion: The creation of different types of Hernia Centers is directed to create two different entities offering the same surgical quality with separate mission: the Referral Center being more dedicated to clinical and surgical activity and High Specialization Centers being more directed to scientific tasks.
MeSH term(s)	Abdominal Wall/surgery ; Certification/methods ; Certification/standards ; Consensus ; Herniorrhaphy/standards ; Humans ; Italy ; Surgicenters/standards
Language	English
Publishing date	2018-05-04
Publishing country	England
Document type	Consensus Development Conference ; Journal Article ; Review ; Systematic Review
ZDB-ID	2212038-5
ISSN	1743-9159 ; 1743-9191
ISSN (online)	1743-9159
ISSN	1743-9191
DOI	10.1016/j.ijsu.2018.04.052
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Article ; Online: Budget Impact Analysis of a Biosynthetic Mesh for Incisional Hernia Repair.

Rognoni, Carla / Bassi, Uberto Andrea / Cataldo, Michele / Crovella, Clotilde / Crovella, Feliciano / Cuccurullo, Diego / Cudemo, Maria / De Nicola, Enrico / De Paolis, Paolo / Greco, Vincenzo Maria / Marioni, Antonio / Pessione, Silvia / Piccoli, Micaela / Rosignoli, Alessandro / Sagnelli, Carlo / Silvestro, Roberto / Tarricone, Rosanna / Trapani, Vincenzo / Soliani, Giorgio

Clinical therapeutics

2018 Volume 40, Issue 11, Page(s) 1830–1844.e4

Abstract: Purpose: With the development of newer prostheses for hernia repair, it is nowadays difficult to understand the total cost of managing patients treated with these advanced medical devices, especially in the complex abdomen, in which various ... ...

Abstract	Purpose: With the development of newer prostheses for hernia repair, it is nowadays difficult to understand the total cost of managing patients treated with these advanced medical devices, especially in the complex abdomen, in which various complications may occur. The aim of this study was to determine the economic implications of these prostheses in order to inform decision making in the management of incisional hernia repair. Methods: A budget impact analysis model was developed to evaluate the economic consequences related to the management of patients undergoing complex (Centers for Disease Control and Prevention wound class II-III or Ventral Hernia Working Group grade 2/3) incisional hernia repair through biosynthetic, synthetic, or biological meshes, from the hospital perspective in Italy. The model was populated with complication rates mainly retrieved from the literature to compare the current scenario with 60%, 10%, and 30% rates of synthetic, biosynthetic, and biological mesh utilization, respectively, with future hypothetical scenarios that consider increasing rates of biosynthetic mesh utilization with respect to the other types of mesh in the next 5 years. Hospital costs of the different events were estimated based on health care resource consumption derived from an electronic survey addressed to key opinion leaders in the field. Findings: The analysis compared the current scenario with future hypothetical scenarios that consider increasing utilization rates of biosynthetic meshes of 25%, 38%, and 44% in the next 1, 3, and 5 years, as estimated by clinicians. Considering 40,000 incisional hernia repairs per year, an increasing use of the biosynthetic meshes may result in a decrease in the total hospital budget of about €153 million in the next 5 years, with a savings per patient of about €770. Implications: The findings of this study support the use of biosynthetic meshes for complex abdominal wall repairs in Italy, showing a potential decrease in the hospital budget in Italy after the diffusion of the new biosynthetic prostheses. Further studies and data from clinical practice would provide additional information to increase the understanding of the economic sustainability of these advanced devices.
MeSH term(s)	Abdominal Wall/surgery ; Hernia, Ventral/surgery ; Herniorrhaphy/economics ; Herniorrhaphy/methods ; Humans ; Incisional Hernia/economics ; Incisional Hernia/surgery ; Italy ; Prostheses and Implants ; Surgical Mesh
Language	English
Publishing date	2018-10-20
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	603113-4
ISSN	1879-114X ; 0149-2918
ISSN (online)	1879-114X
ISSN	0149-2918
DOI	10.1016/j.clinthera.2018.09.003
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Article ; Online: Minor-but-Complex Liver Resection: An Alternative to Major Resections for Colorectal Liver Metastases Involving the Hepato-Caval Confluence.

Urbani, Lucio / Masi, Gianluca / Puccini, Marco / Colombatto, Piero / Vivaldi, Caterina / Balestri, Riccardo / Marioni, Antonio / Prosperi, Valerio / Forfori, Francesco / Licitra, Gabriella / Leoni, Chiara / Paolicchi, Adriana / Boraschi, Piero / Lunardi, Alessandro / Tascini, Carlo / Castagna, Maura / Buccianti, Piero

Medicine

2015 Volume 94, Issue 29, Page(s) e1188

Abstract: Major hepatectomy (MH) is often considered the only possible approach for colorectal liver metastasis (CRLM) at the hepato-caval confluence (CC), but it is associated with high morbidity and mortality. With the aim to reduce MH, we developed the "minor- ... ...

Abstract	Major hepatectomy (MH) is often considered the only possible approach for colorectal liver metastasis (CRLM) at the hepato-caval confluence (CC), but it is associated with high morbidity and mortality. With the aim to reduce MH, we developed the "minor-but-complex" (MbC) technique, which consists in the resection of less than 3 adjacent liver segments with exposure of the CC and preservation of hepatic outflow until spontaneous maturation of peripheral intrahepatic shunts between main hepatic veins. We have evaluated applicability and outcome of MbC resections for the treatment of CRLM involving the CC. In this retrospective cohort study, all consecutive liver resections (LR) performed for CRLM located in segments 1, 7, 8, or 4a were classified as MINOR - removal of <3 adjacent segments; MbC - removal of <3 adjacent segments with CC exposure; and MH - removal of ≥ 3 adjacent segments. The rate of avoided MH was obtained by the difference between the rate of potentially MH (PMH) plus potentially inoperable cases and the rate of the MH performed. Taking into account that postoperative mortality is mainly related to the amount of resected liver, MbC was compared with minor resections for safety, complexity, and outcome. Of the 59 LR analyzed, 29 (49.1%) were deemed PMH and 4 (6.8%) potentially inoperable. Eventually, MH was performed only in 8 (13.5%) with a decrease rate of 42.4%. Minor LR was performed in 23 (39.0%) and MbC LR in 28 (47.5%) patients. Among MbC cases, 32.1% had previous liver treatments, 39.3% required vascular reconstruction (no reconstructed vessel thrombosis occurred before maturation of peripheral intrahepatic shunts between main hepatic veins), and 7.1% had grade IIIb-IV complications, their median hospital stay was 9 days and 90-day mortality was 0%. After a median follow-up of 22.2 months, oncological results were comparable with those of minor resections. MbC hepatectomy lowers the need for MH and allows for the resection of potentially inoperable patients without negative impact on safety and survival.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms/pathology ; Colorectal Neoplasms/therapy ; Combined Modality Therapy ; Female ; Hepatectomy/methods ; Humans ; Liver/blood supply ; Liver/pathology ; Liver Neoplasms/secondary ; Liver Neoplasms/surgery ; Liver Neoplasms/therapy ; Male ; Middle Aged ; Retrospective Studies
Language	English
Publishing date	2015-07-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000001188
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Article ; Online: Serum IGF-binding protein 2 (IGFBP-2) concentrations change early after gastric bypass bariatric surgery revealing a possible marker of leptin sensitivity in obese subjects.

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Article ; Online: Clinical outcomes and quality of life associated with the use of a biosynthetic mesh for complex ventral hernia repair: analysis of the "Italian Hernia Club" registry.

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Article: Gestione del paziente sottoposto a colecistectomia laparoscopica in One Day Surgery.

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Article ; Online: Defining the characteristics of certified hernia centers in Italy: The Italian society of hernia and abdominal wall surgery workgroup consensus on systematic reviews of the best available evidences.

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Article ; Online: Budget Impact Analysis of a Biosynthetic Mesh for Incisional Hernia Repair.

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Article ; Online: Minor-but-Complex Liver Resection: An Alternative to Major Resections for Colorectal Liver Metastases Involving the Hepato-Caval Confluence.

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